Health Systems Strengthening Innovations In Policy, Processes and Technology- Bhudeb Chakravarti, National Institute for Smart

  • 249 views
Uploaded on

 

  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Be the first to comment
    Be the first to like this
No Downloads

Views

Total Views
249
On Slideshare
0
From Embeds
0
Number of Embeds
1

Actions

Shares
Downloads
0
Comments
0
Likes
0

Embeds 0

No embeds

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
    No notes for slide

Transcript

  • 1. Need for Process Reengineering in Healthcare Bhudeb Chakravarti Senior General Manager & Region Head National Institute for Smart Government
  • 2.
    • Long Queues at OPD
    • Air of Mystification about status of patient
    • There is no need assessment of requirement of “Admission to Hospital” or “Days of Stay”
    • Multiple Visits to Hospitals for same treatment
        • Sometimes to other hospitals (so called Multi-Speciality Hospitals)
    • Outcome is in Suspense (Either time of cure or chance of cure)
    • Poor Quality of Service (Most of the time it is next to impossible to measure the Quality)
    • Doctor is the Final Decision Maker
    Symptoms of Poor Healthcare Processes
  • 3. Symptoms of In-Efficient HIS
    • Extensive Information Exchange & Multiple Entry of Data (Some data not verified)
    • Doctors now suffer from the “information paradox”, drowning in information but cannot find the information they need
    • Patient information is often neither evidence based nor easily accessible
    • No EMR  No way of accessing Critical Care Data
    • Too many Controls and Checks
    • 60% of Clinician time is spent searching or waiting for patient information
    • Exception is the Rule
  • 4. Value to Patient
    • The core issue in Healthcare is the value of healthcare delivered
    • The extent of medical errors is largely unknown
      • Unnecessary deaths are attributed to medication related errors, unneeded or ineptly performed surgeries
      • Heavy reliance on paper based patient records in medical institutions
      • Untimely or mistaken diagnoses
      • Repeat of the data collection process (in the process missing some vital test results)
      • Old factors are often missed as data not available
  • 5. Recommended Steps
    • Streamline Key Processes through Business Process Re-engineering (BPR)
    • Capture Information at Source
    • Identify Key Performance Indicators and Evaluate the Performance Accordingly
    • Simplify Reporting Formats
    • Single Integrated Collection of Data (No Multiple Registers)
    • Track and Monitor Each Process on Regular basis
    • All the information available to professional should be available to patients
  • 6. Definition of BPR
    • Business Process Reengineering is
        • “ the fundamental rethinking and redesign of business processes to achieve dramatic improvements in critical contemporary measures of performance such as cost, quality, service and speed.”
            • - Hammer and Champy
  • 7. Basic Principles of BPR
    • Organize around outcomes, not tasks
    • Identify all the processes in an organization and prioritize them in order of redesign urgency
    • Integrate information processing work into the real work that produces the information
    • Treat geographically dispersed resources as though they were centralized
    • Link parallel activities in the workflow instead of just integrating their results
    • Put the decision point where the work is performed, and build control into the process
    • Capture information once and at the source
  • 8. Key Process Parameters Safety and Quality Effective and Evidence Based Patient Centered: Patient Values Guide Devisions Timely: Reduced Waiting Times and Delays Efficient: Avoid Wastes Equitable: Care doesn’t vary by Gender, Class or Status
  • 9. Transformation of Healthcare Professionals as Authorities  Professionals as Partners  Professionals as Facilitators Self Help Networks Friends and Family Individual Self Care Reduced Cost, Increased Value
  • 10. Collaboration & Standardisation Investigation Labs Pharmacies Employer Equipment Suppliers PATIENT Insurance Providers Healthcare Providers
  • 11. NKC Recommendations
    • Initiate development of Indian Health Information Network
    • Establish national standards for clinical terminology and health informatics
    • Create a common electronic health record (EHR)
    • Frame policies to promote use of IT in health care
    • Create appropriate policy framework to protect health data of citizens
    • Medical Informatics to be part of medical and paramedical curriculum
    • Create an institution framework for implementation
  • 12. Recommended Functionalities
    • Wide Area Health Network
    • EMR including Physician Order Entry System (e-Prescriptions and e-Referral)
    • Reduction of waiting Times between when Lab Results are requested and when they are delivered through the utilisation of faster communication technologies such as email.
    • Reconfigure laboratories so that they can perform the most frequently requested tests faster
    • Share critical patients between Hospitals so that both facilities have similar capacity levels. This is more efficient than taking on patients until capacity is reached
    • Synchronise the physical and virtual parts of processes
    • Clinical Decision Support systems (CDS) must be carefully designed so that they are reliable and accurate
  • 13. Conclusion
    • Knowing is not enough;
    • we must apply.
    • Willing is not enough;
    • we must do.
    • - Johann Wolfgang von Goethe
  • 14. Any Queries [email_address]